Non-Surgical Management of Trigonocephalic Patients: An OCT and 3D-CT Based Follow-up Study.

Aim: To evaluate the cosmetic and visual aspects of trigonocephaly patients who have not received surgical intervention throughout a long-term follow up.

Material and methods: Patients with trigonocephaly who did not undergo surgery were evaluated. Using 3D computed tomography images, the frontal (angle of the 2 lines between the bilateral pterion and nasion) and interfrontal angles were measured, and the frontal projections at the first and last examinations were compared. The final appearance was photographed, and detailed eye examinations and optical coherence tomography (OCT) measurements were performed.

Results: The study included 6 patients (3 male and 3 female patients). The patient age at diagnosis was between 3 months and 2 years. The mean age at diagnosis was 10.33 months, and the average follow up period was 34 months. The interfrontal angle was not below 118° in any of our patients. We noted that the interfrontal angle increased with an increase in the follow up period. The ophthalmologic examination differed according to the age of the patients. Extraocular motility testing revealed no abnormalities. The anterior segment and fundus examination results were within normal limits. Bilateral OCT images of the optic discs revealed normal retinal nerve fiber layer (RNFL) thickness. No problems were detected in the neurocognitive development of the patients, and no severe cosmetic pathology was observed.

Conclusion: Neurocognitive retardation and ophthalmologic problems were not detected in our patients with trigonocephaly who did not undergo surgery. More detailed studies with larger sample sizes are required before changing our approach to the treatment of trigonocephaly.